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When skin-deep is all you need

Working with faculty at Yale School of Medicine’s Department of Dermatology, two Yale undergrads built a device that’s helping doctors diagnose skin conditions from afar.

Illustrated by Matthew Daley
When skin deep is all you need

Elizabeth Asai, Yale College ’13, never dreamed she would one day co-found and run her own company. To her, entrepreneurship seemed too chaotic a way to make a living. “I thought I’d go to medical school or work for a larger tech company,” Asai says.

Fate intervened in 2011 when Asai and fellow Yale undergrad Elliot Swart entered a Boston-based student contest to build a primary-care medical device. The contest offered large cash prizes so winners could turn their prototypes into marketable products.

Before the contest, the pair—Asai was a biomedical engineering student, Swart was studying electrical engineering and computer science—had been working on what they now acknowledge was an overly ambitious project. They were trying to develop a probe that used 3D imaging technology to assess the texture and elasticity of such internal tissues as tumors.

Realizing their product would not fit the primary-care focus of the contest, Swart and Asai shifted gears. They decided to use knowledge they’d acquired in their first project to create a new, simpler device that took 3D pictures of skin to assist dermatology diagnoses.

Asai and Swart’s instincts proved spot on—their new device won second prize and $100,000. Key to the pair’s second-place finish was assistance from Yale School of Medicine’s Department of Dermatology. Doctors there fast-tracked a clinical study of the product involving 50 patients, producing results in just four months, Asai says. The 30-page writeup documented that their product works—a vital piece of their contest submission, Asai says.

Swart and Asai used the money to further develop their idea. The next year they founded a company they dubbed 3Derm Systems, evoking the firm’s combination of 3D imaging and dermatology.

Seven years later, 3Derm is thriving. The Boston-based company has a network of over 250 primary-care physicians using its 3D imaging and telemedicine products, Asai says. She is the company’s CEO, while Swart is its chief technology officer. The pair, now both 27, express deep satisfaction with the company’s success.

“I can definitely say it’s been a rewarding experience taking a product all the way through its life cycle, from its inception and experimentation, to commercialization and getting to see patients use it,” says Swart, who got so involved in the firm that he left Yale shortly before finishing his degree. “I think it was more rewarding to me than I would have anticipated.”

Yale was “very important” to their success, Asai says. In addition to early encouragement and assistance from the engineering department and Yale School of Medicine, the school also helped with the business side. “We knew the engineering and clinical needs,” Asai says. “But we really didn’t know how to pair that with a business model.”

Yale Entrepreneurial Institute paired them with an experienced serial entrepreneur who provided a crash course in business. He also introduced them to Blue Cross Blue Shield, which became and remains their biggest investor.

Over time, 3Derm’s product has evolved from straight 3D imaging of skin into a cloud-based dermatology platform, Swart says. Doctors who sign up receive one of the firm’s proprietary 3D cameras. When they see a problematic lesion or skin condition, they take a photo that is uploaded into the cloud, Asai says. Dermatologists chosen by the primary-care offices then examine the cases remotely to determine whether the patient needs to be seen in person.

“This is not dermatology in a box, where we have a room full of dermatologists reading cases all day,” Asai says. “All of the dermatologists we work with are out seeing patients in person.”

The company guarantees an answer within 72 hours, but typically provides one in 12 hours, she says. That’s much faster than scheduling appointments with dermatologists, who have wait times as long as 100 days. It also saves money because dermatologists conclude in 54% of cases that the patient can be treated in primary care, eliminating the need for an office visit. And when a skin issue is flagged, diagnosis and treatment can arrive faster, saving money and lives.

3Derm may have come a long way, but it is just getting started, Asai says. The firm is hard at work developing algorithms with diagnostic and triage functions, avoiding the need for referrals. One algorithm would help manage psoriasis, while the other will do the same for skin lesions. The firm expects to deploy one of the systems in the near future, Asai says.

3Derm remains privately held with no near-term plans to go public. Even discussing such a development is premature. “I think it is far enough in the future that we laugh when we hear that question,” she says.